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Monday, August 20, 2018

Diabetic Polyneuropathy and the Whole Foods Plant Based No Oil Diet #FoodisMedicine

Diabetic Polyneuropathy and the Whole Foods Plant Based No Oil Diet
  Allan Kalmus, DPM
www.01Reluctantvegan.blogspot.com

Diabetic Neuropathy is described by patients as manifesting itself in a number of different ways. Some experience painful burning sensation that keeps them up at night. Others feel like their feet are freezing even though the skin feels warm to touch. There can be the feeling like an insect is crawling on you or you may get sudden sharp electrical shocks that radiate into the foot or up the leg. There may be partial or complete numbness in the toes but normal sensation in the arch and heel. The entire foot may be numb and it can extend into the lower leg as well. The patient may lose the ability to tell where their foot is in space affecting balance and gait. The joints in the foot lose the ability to signal the brain when they are under stress. This will cause the joints to degenerate resulting in collapse of the arches and even a “rocker bottom” foot structure. Skin ulcers may form and easily become infected. There can also be hypersensitivity with the patient experiencing severe pain with light touch. Even the act of putting on a sock can be almost unbearable. The skin may become very dry with changes in texture and color as the autonomic nervous system becomes involved and the ability to perspire is lost.
   
Although Type 1 and Type 2 Diabetics can both develop neuropathy, it appears to affect the Type 2 Diabetic earlier in the course of the disease. These findings are consistent with the pathology on the cellular level coming from 2 or more separate pathways. In the Type 2 Diabetic the Insulin Resistance associated with Intramyocellular lipid accumulation prevents glucose from being transported across the muscle cell membrane where it can be metabolised. The nerve cells act in much the same way as the muscle cells in that their preferred fuel is glucose. In the presence of trans fats the glucose is not able to cross the cell wall and the neurons are starving. The stress on the nerve cells causes them to send the pain signals to the brain as a sign that something is dreadfully wrong.
    
The healthy nerve cells also require adequate microcirculation to bring in Oxygen and glucose as fuel and to remove waste. The blood vessels are microscopic and will lose flow when plaques form just as in any of the larger arteries. In the Diabetic, the presence of peripheral neuropathy symptoms are an early warning sign of atherosclotic changes that also affect the heart, brain and kidneys. It doesn’t take much plaque to clog a microscopic blood vessel.   Consider it another “Canary in the Coal Mine” much like Erectile Dysfunction being an early warning sign of Coronary Artery Disease.
The numbness can be correlated with a decrease is the number of superficial nerve fibers  in the skin on biopsy.

   Normal Nerve Fiber Density                                

Nerve Axon Swelling with loss of Fiber Density

    In my practice, once we establish that the limb has sufficient circulation to avoid amputation my patient and I will discuss both their medications and their lifestyle. Along with quitting smoking, increasing activity and medications I always discuss their diet. Without fail they will describe a diet high in animal products and low in fruits, vegetables, whole grains and anything they have been told is starchy. Basically The American Diabetes Association Diet in one form or another. I have them watch the trailers for Forks Over Knives and Eating You Alive just to establish some mainstream credibility. If they see it on a computer or TV they tend to give it more credence than coming from me. I tell them that what they are doing is not working for them and that they are not going to get better without making the dietary changes that will eliminate animal fats from their diet. In my mind, if I don’t at least give them the option to learn what they are doing wrong and how they can help themselves without medication I’m doing them a huge disservice. Whether I think they are capable of making the necessary changes or not is irrelevant. All I can do is give them enough information to know that the option to get off most of their medications is out there and that there is a clear, safe and effective pathway to get where they want to go.
    Every one of my patients who have listened and made the simple dietary changes to a whole food plant based no oil diet have responded with a decrease in their Neuropathic Pain symptoms within 6 weeks. The patients with numbness notice gradual return of feeling in their feet in 6 months to a year. A subsequent skin biopsy after changing over for 6 months will show return of normal nerve fiber density. The dry skin disappears. They all lose weight, improve their blood pressure and become more active as the pain in their feet disappears. The need for medication to control their sugar in the Type 2 Diabetics is either eliminated or severely reduced. The more compliant they are the less medication they need. The Type 1 Diabetics find that they need far less daily Insulin. They all come back from their Primary Care Doctor visits stating that they were told: “Whatever you’re doing, keep doing it!”
    If you are suffering from the symptoms of Diabetic Neuropathy there is not a pill, miracle food, shot, therapeutic modality or surgery that will give you the long term relief you want. Changing your diet and lifestyle are your best bet and won’t cost you a thing. The only dietary supplement you need is a very tiny amount of over the counter Vitamin B12. It is not essential that you buy all organic produce and you don’t have to join a gym or hire a trainer. You’ll get plenty of protein from plants the same way gorillas, buffalo, horses, cows, giraffes, elephants, deer, etc. do. There are no side effects. Anyone can do this. All you have to do is convince yourself that you want to take control and that your well being is worth it!!!

For an excellent collection of references go to:

Thanks to Bako Labs for the photomicrographs of nerve fibers.